Insurance Verifications Specialist

Insurance Verification Specialist

Ultimate Staffing Services is actively seeking a dedicated Insurance Verification Specialist to join a reputable healthcare team in Florida. This role is essential for ensuring accurate insurance verification for clinic and outpatient surgery appointments, counseling patients regarding their financial responsibilities, and collecting payments prior to procedures. The successful candidate will thrive in a team environment, demonstrating flexibility in accepting work and a strong customer service focus to effectively interact with patients, doctors, staff, and management.

Responsibilities:

• Possess a solid understanding of medical insurance, including deductibles, copay, and coinsurance.
• Verify and interpret medical benefits for Medicare, Medicaid, major commercial health insurance, and secondary payers.
• Process provider referrals and prior authorization requests.
• Utilize knowledge of medical terminology and ICD-10 codes and diagnoses.
• Verify patient eligibility via payer websites or telephone to determine coverage of benefits and calculate patient responsibility for services scheduled.
• Add or update patient insurance, both primary and secondary, in the EHR system.
• Understand individual payer guidelines and authorization/referral requirements, communicating with insurance companies to provide necessary clinical documentation.
• Ensure complete and accurate information is maintained in patient accounts, including authorizations or referrals from payers or Primary Care Physicians.
• Exhibit strong people skills, being diplomatic, patient, flexible, and capable of multitasking and cross-training on all functions within the Insurance Verification Department.
• Maintain mobility in an office setting, including sitting, standing, walking, and bending.
• Perform general duties and other functions as required or assigned.
• Utilize a working knowledge of Microsoft Suite, including Excel, Word, and Outlook.

Requirements:

• Work Hours: Monday to Friday, First Shift

Benefits:

• Max Pay: $24 per hour
• Min Pay: $19 per hour

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.